AXEIS Workshop Liability Waiver & Photo Release Form

Student Information

First name

Last name

Student Email

Parent Name

Parent Email

Parent Phone Number

Workshops will be hosted at the following addresses:

16536 Crescent Creek Drive, San Diego, CA 92127
13001 Moonstone Place, San Diego, CA 92129

Liability Waiver

I, the undersigned parent or legal guardian of the above-named student (“Participant”), understand and acknowledge that:

AXEIS STEM workshops are held at private residences of high school mentors.
All workshops are supervised by an adult.
Participation involves inherent risk.

I voluntarily assume all risks and release, waive, and hold harmless AXEIS, its officers, volunteers, mentors, adult supervisors, and the homeowners from any liability.

I have read and agree to the terms of the Liability Waiver.

Medical Consent

In case of emergency, I authorize AXEIS volunteers to seek medical care if I cannot be reached.

Agree

Disagree

Photo & Media Release

Do you give AXEIS permission to use photos/video of your child for promotional purposes?

Yes, I consent to photo/media use as stated above.

No, I do not consent to the use of my child’s image or likeness.

Signature & Acknowledgment

By submitting this form, I confirm that:

I have read and understood this release form.
I agree to the terms and conditions above.
This release applies to me, my child, and our legal representatives.

Signature

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Date

This constitutes my digital signature.

Advancing eXcellence in Exploration, Innovation and Science

AXEIS

AXEIS Workshop Liability Waiver & Photo Release Form

Liability Waiver

Medical Consent

Photo & Media Release

Signature & Acknowledgment

Advancing eXcellence
in Exploration, Innovation
and Science